Reducing Pain During Intrauterine Device Insertion

Akers, Aletha Y.; Steinway, Caren; Sonalkar, Sarita; Perriera, Lisa; Schreiber, Courtney A.; Harding, Jennifer; García-España, J. Felipe

doi:10.1097/aog.0000000000002242

Cited by 50 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For comparative reasons, median VAS scores for peripheral intravenous cannula insertion with or without lidocaine cream were reported to be 3.0 and 7.0, respectively 22. Our data compare favorably with a recent study applying conventional paracervical block for IUD insertion 23. In this study, the median VAS score after IUD insertion in 47 women was 30.0 (95% CI, 20.0–58.0) on a 100-mm VAS.…”

Section: Discussionsupporting

confidence: 76%

Uterine and Tubal Lavage for Earlier Cancer Detection Using an Innovative Catheter: A Feasibility and Safety Study

Maritschnegg

Heitz

Pecha

et al. 2018

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectivesPoor survival of high-grade serous pelvic cancer is caused by a lack of effective screening measures. The detection of exfoliated cells from high-grade serous pelvic cancer, or precursor lesions, is a promising concept for earlier diagnosis. However, collecting those cells in the most efficient way while fulfilling all requirements for a screening approach is a challenge. We introduce a new catheter for uterine and tubal lavage (UtL) and the clinical evaluation of its performance.Methods/MaterialsIn study I, the clinical feasibility of the UtL using the new catheter was examined in 93 patients admitted for gynecologic surgery under general anesthesia. In study II, the safety of the UtL procedure was assessed. The pain during and after the UtL performed under local anesthesia was rated on a visual analog scale by 22 healthy women.ResultsIn study I, the UtL was carried out successfully in 92 (98.9%) of 93 cases by 16 different gynecologists. It was rated as easy to perform in 84.8% of patients but as rather difficult in cancer patients (odds ratio, 5.559; 95% confidence interval, 1.434–21.546; P = 0.007). For benign conditions, dilatation before UtL was associated with menopause status (odds ratio, 4.929; 95% confidence interval, 1.439–16.884; P = 0.016). In study II, the pain during UtL was rated with a median visual analog scale score of 1.6. During a period of 4 weeks after UtL, none of the participants had to use medication or developed symptoms requiring medical attention. The UtL took 6.5 minutes on average. The amount of extracted DNA was above the lower limit for a sensitive, deep-sequencing mutation analysis in all cases.ConclusionsOur studies demonstrate that the UtL, using the new catheter, is a safe, reliable, and well-tolerated procedure, which does not require elaborate training. Therefore, UtL fulfils all prerequisites to be used in a potential screening setting.

show abstract

Section: Discussionsupporting

confidence: 76%

Uterine and Tubal Lavage for Earlier Cancer Detection Using an Innovative Catheter: A Feasibility and Safety Study

Maritschnegg

Heitz

Pecha

et al. 2018

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…The study by Akers et al showed a decrease in pain with 10 cc 1% lidocaine block, but had used the smaller LNG-13.5 mg (Skyla) IUD with adolescent participants who were 14–25 years old. 18 A phase II trial of lower-dose LNG IUDs demonstrated less pain associated with insertion of these smaller-framed IUDs compared to the LNG 52 mg IUD (Mirena). 28 Our study includes nulliparous women 18–45 years old receiving mostly the larger-framed LNG 52 mg and CuT380A IUDs, which are the most commonly utilized IUDs in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 A trial utilizing a 10 cc 1% lidocaine block demonstrated a decrease in pain with IUD placement among nulliparous adolescents (14–25 years old) receiving the LNG-13.5 mg IUD (Skyla). 18 The LNG-52 mg and copper IUDs have slightly larger applicators, so it is difficult to extrapolate these results. This study evaluates if a 20 cc buffered 1% lidocaine paracervical block will decrease pain with IUD placement.…”

Section: Introductionmentioning

confidence: 99%

Paracervical Block for Intrauterine Device Placement Among Nulliparous Women

Mody

Farala

Jimenez

et al. 2018

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…The CONSORT guidelines were followed to design and report the trial; full details regarding the trial are repored elsewhere. 16 The protocol is available by request. Institutional Review Board (IRB) approval was obtained from the Children’s Hospital of Philadelphia (CHOP, which was the IRB of record), Hospital of the University of Pennsylvania, and Thomas Jefferson University, all of which performed study visits.…”

Section: Methodsmentioning

confidence: 99%

Satisfaction With the Intrauterine Device Insertion Procedure Among Adolescent and Young Adult Women

Akers

Harding

Perriera

et al. 2018

Obstetrics &Amp; Gynecology

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To evaluate satisfaction with intrauterine device (IUD) insertion procedures among adolescent and young adult women. METHODS This secondary analysis of data from a multisite, single-blind, sham-controlled randomized trial of women having a levonorgestrel 13.5 mg IUD inserted enrolled participants from March 2015 through July 2016 at 3 family planning clinics in Philadelphia, Pennsylvania. Eligible women were 14 to 22 years, nulliparous, not pregnant, and English speaking. Randomization was via computer generated allocation in block sizes of 4 to a 1% lidocaine paracervical or sham block. Only patients were blinded. Satisfaction was measured with 3-items that assessed overall satisfaction with the procedure, whether participants would recommend the IUD to friend, and the perception that the IUD was worth the discomfort. Predictors included demographics, sexual and reproductive history, pain following IUD insertion, and treatment group. RESULTS Ninety-five women enrolled; 93 (97.9%) were included in the analysis. Forty-five (47.4%) were white, 34 (36.0%) were black, 62 (66.0%) privately insured, and 75 (79.0%) previously used contraception. Most (n=71, 76.8%) reported high overall satisfaction with the procedure, 62 (67.4%) would recommend an IUD to a friend, and 77 (83.2%) perceived the IUD was worth the discomfort. The odds of reporting high overall satisfaction were lower among adolescents compared to young adults (OR 0.07, 95% CI: 0.008, 0.68); those who never had a gynecologic exam compared to those who had (OR 0.26; 95% CI: 0.069, 0.99); and decreased as pain score increased (OR 0.96; 95% CI: 0.94, 0.99). Higher pain scores were negatively correlated with the odds of recommending an IUD to a friend and perceiving the IUD was worth the discomfort. CONCLUSION Adolescent and young adult women report high levels of satisfaction following the IUD insertion procedure. Young age, lack of experience with gynecologic exams, and high pain were inversely related to satisfaction. Clinical Trial Registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT02352714.

show abstract

Reducing Pain During Intrauterine Device Insertion

Abstract: ClinicalTrials.gov, NCT02352714.

Cited by 50 publications

References 19 publications

Uterine and Tubal Lavage for Earlier Cancer Detection Using an Innovative Catheter: A Feasibility and Safety Study

Uterine and Tubal Lavage for Earlier Cancer Detection Using an Innovative Catheter: A Feasibility and Safety Study

Paracervical Block for Intrauterine Device Placement Among Nulliparous Women

Satisfaction With the Intrauterine Device Insertion Procedure Among Adolescent and Young Adult Women

Contact Info

Product

Resources

About